BILL NUMBER: AB 2547	CHAPTERED  09/29/00

	CHAPTER   842
	FILED WITH SECRETARY OF STATE   SEPTEMBER 29, 2000
	APPROVED BY GOVERNOR   SEPTEMBER 28, 2000
	PASSED THE SENATE   AUGUST 31, 2000
	PASSED THE ASSEMBLY   AUGUST 31, 2000
	AMENDED IN SENATE   AUGUST 31, 2000
	AMENDED IN ASSEMBLY   MAY 24, 2000
	AMENDED IN ASSEMBLY   MAY 1, 2000

INTRODUCED BY   Assembly Member Hertzberg and Senator Polanco
   (Principal Coauthors:  Assembly Members Calderon, Cardenas,
Cedillo, Ducheny, Firebaugh, Gallegos, Havice, Nakano, Reyes, Romero,
Villaraigosa, Vincent, Washington, Wesson, and Roderick Wright)
   (Coauthors:  Senators Escutia and Solis)

                        FEBRUARY 24, 2000

   An act to add Section 14085.54 to the Welfare and Institutions
Code, relating to health facilities.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2547, Hertzberg.  Health facilities.
   Existing law provides for the Medi-Cal program, administered by
the State Department of Health Services, under which qualified
low-income persons are provided with health care services.
   Existing law generally defines a disproportionate share hospital
as a hospital that has disproportionately higher costs, volume, or
services related to the provision of services to Medi-Cal or other
low-income patients than the statewide average.  Under existing law,
an eligible disproportionate share hospital may receive supplemental
Medi-Cal reimbursement to defray a portion of the debt service cost
for an eligible capital project.
   This bill would provide that the Los Angeles County University of
Southern California Medical Center capital project that met initial
eligibility criteria for supplemental reimbursement may develop and
submit revised final plans for a revised capital project and shall
qualify for supplemental reimbursement for the revised capital
project if it meets unspecified criteria.  It would permit the
revised capital project plan to provide for specified types of
changes from the original project plan.
   This bill would require the state and Los Angeles County to
complete a report assessing the health care needs of the county, as
specified, and to implement jointly agreed-upon recommendations, to
the extent that they do not require statutory authorization.
   Because Los Angeles County is required to complete a prescribed
report, it would create a state-mandated local program.
  No reimbursement is required by this act pursuant to Section 6 of
Article XIIIB of the California Constitution because the only costs
that may be incurred by a local agency or school district are the
result of a program for which legislative authority was requested by
that local agency or school district, within the meaning of Section
17556 of the Government Code and Section 6 of Article XIIIB of the
California Constitution.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Section 14085.54 is added to the Welfare and
Institutions Code, to read:
   14085.54.  (a) The Los Angeles County University of Southern
California (LAC-USC) Medical Center may submit revised final plans to
the Office of Statewide Health Planning and Development to replace
the original capital expenditure project plans that met the initial
eligibility requirements provided for under Section 14085.5 if all of
the following conditions are met:
   (1) The revised capital expenditure project meets all other
requirements for eligibility as specified in Section 14085.5.
   (2) The revised plans are submitted to the Office of Statewide
Health Planning and Development on or before December 31, 2002,
except that, with respect to a facility in the San Gabriel Valley of
not less than 80 beds, the revised plans may be submitted not later
than December 31, 2003.
   (3) The scope of the capital project shall consist of two
facilities with not less than a total of 680 beds.
   (b) Funding under Section 14085.5 shall not be provided unless all
of the conditions specified in subdivision (a) are met.
   (c) The revised plans for the LAC-USC Medical Center Capital
expenditure project may provide for one or more of the following
variations from the original capital expenditure project plan
submission:
   (1) Total revisions or reconfigurations, or reductions in size and
scope.
   (2) Reduction in, or modification of, some or all inpatient
project components.
   (3) Tenant interior improvements not specified in the original
capital expenditure project plan submission.
   (4) Modifications to the foundation, structural frame, and
building exterior shell, commonly known as the shell and core.
   (5) Modifications necessary to comply with current seismic safety
standards.
   (6) Expansion of outpatient service facilities that operate under
the LAC-USC Medical Center license.
   (d) The revised capital expenditure project may provide for an
additional inpatient service site to the current LAC-USC Medical
Center only if the additional inpatient service site meets both of
the following criteria:
   (1) The San Gabriel Valley site is owned and operated by the
County of Los Angeles.
   (2) The San Gabriel Valley site is consolidated under the LAC-USC
Medical Center license.
   (e) (1) Supplemental reimbursement for the revised capital
expenditure project for LAC-USC Medical Center, as described in this
section, shall be calculated pursuant to subdivision (c) of Section
14085.5, as authorized and limited by this section.  The initial
Medi-Cal inpatient utilization rate for the LAC-USC Medical Center,
for purposes of calculating the supplemental reimbursement, shall be
that which was established at the point of the original capital
expenditure project plan submission.  The revised capital expenditure
project costs, including project costs related to the additional
inpatient service site, eligible for supplemental reimbursement under
this section shall not exceed 85 percent of the project costs,
including all eligible construction, architectural and engineering,
design, management and consultant costs that would have qualified for
supplemental reimbursement under the original capital project.  The
Legislature finds that the original qualifying amount was one billion
two hundred sixty-nine million seven hundred thirty-five thousand
dollars ($1,269,735,000).
   (2) Notwithstanding any other provision of this section, any
portion of the revised capital expenditure project for which the
County of Los Angeles is reimbursed by the Federal Emergency
Management Agency and the State Office of Emergency Services shall
not be considered eligible project costs for purposes of determining
supplemental reimbursement under Section 14085.5.
   (3) The department shall seek a medicaid state plan amendment in
order to maximize federal financial participation.  However, if the
department is unable to obtain federal financial participation at the
Medi-Cal inpatient adjustment rate as described in paragraph (1),
the state shall fully fund any amount that would otherwise be funded
under this section, but for which federal financial participation
cannot be obtained.
   (f) The LAC-USC Medical Center shall provide written notification
to the department of the status of the project on or before January 1
of each year, commencing January 1, 2002.  This notification shall,
at a minimum, include a narrative description of the project,
identification of services to be provided, documentation
substantiating service needs, projected construction timeframes, and
total estimated revised capital project costs.
   (g) The project, if eligible under the criteria set forth in this
section and Section 14085.5, shall commence construction at both
facilities referred to in subdivision (a) on or before January 1,
2004.
   (h) In addition to the requirements of subdivision (f), the
project shall be licensed for operation and available for occupancy
on or before January 1, 2009.
   (i) On or before August 15, 2001, the County of Los Angeles may
withdraw any revised final plans that are submitted pursuant to this
section prior to that date if the Board of Supervisors of Los Angeles
County finds that insufficient funds are available to carry out the
capital expenditure project described in this section.
  SEC. 2.  (a) The Legislature finds and declares that in an effort
to protect the fragile health care delivery system of Los Angeles
County, an objective analysis of the community's health care needs is
required.
   (b) Therefore, two years prior to obtaining the certificate of
occupancy for the LAC-USC Medical Center replacement facility
referred to in subdivision (a) of Section 14085.54 of the Welfare and
Institutions Code, the Legislature and Los Angeles County shall
complete a report that assesses the health care needs of the
residents of the county and the catchment area of the LAC-USC Medical
Center.  The role of the Women's and Children's Hospital in meeting
the community's needs shall be included in this report.  The report
shall be submitted to the Governor for review.
   (c) Each recommendation jointly agreed to by the state and the
Board of Supervisors of Los Angeles County shall be submitted to the
Legislature for consideration.  The state and Los Angeles County
shall, in good faith, implement the jointly agreed recommendations
not otherwise requiring statutory change.
  SEC. 3.  No reimbursement is required by this act pursuant to
Section 6 of Article XIIIB of the California Constitution because the
only costs that may be incurred by a local agency or school district
are the result of a program for which legislative authority was
requested by that local agency or school district, within the meaning
of Section 17556 of the Government Code and Section 6 of Article
XIIIB of the California Constitution.
